Study: Impact of PEAK Methodology on Interdialytic Weight Gain: A Multi-Center Experience

Hemodialysis patients who experience larger interdialytic weight gain (IDWG) are at higher risk of cardiovascular and all-cause mortality and diastolic dysfunction (which may directly reduce survival). Patients who experience an IDWG of greater than four percent of dry weight may experience a substantially higher risk of death.

A study conducted in 15 dialysis clinics in Saudi Arabia aimed to determine whether the implementation of Pursuing Excellence by Advancing Knowledge (PEAK) methodology, which is based on six sigma and lean processes, could help reduce the percentage of patients experiencing an IDWG of greater than four percent. The PEAK method aims to instill continuous improvement principles at the clinic level. A key component of the PEAK method is a daily team huddle that focuses on the key performance indicator (in this case, IDWG).

At baseline, the percentage of patients with IDWG greater than four percent ranged from 20.5 percent to 66.1 percent across clinics. At nine months after the PEAK methodology was implemented, the percentage of patients with IDWG greater than four percent ranged from 15.6 to 63.7 percent.

By implementing the PEAK methodology and encouraging teams to focus on the defined outcome of IDWG less than four percent, all of the clinics in the study achieved a decrease in the frequency of IDWG in their patient populations.

For more information, read the research poster (which was presented at ASN) here.